Helicobacter pylori infection in the young in Bangladesh: prevalence, socioeconomic and nutritional aspects.

ABSTRACT

PIP: The gastric acid barrier is an important host defense against small bowel infection. The integrity of that barrier, however, may be compromised by infection with Helicobacter pylori. The authors investigated the prevalence of H. pylori infection among 469 children aged 1-99 months in a poor, periurban, Bangladeshi community and explored its association with socioeconomic and nutritional status. The children's parents were interviewed via questionnaire, while a C-urea breath test was conducted and weight recorded on a beam balance with a sensitivity of 20 g to detect active infection with H. pylori. 61% of 36 infants aged 1-3 months tested positive for H. pylori. However, the rate of infection declined steadily with increasing age to reach 33% among children aged 10-15 months. The rate of infection then rose to 84% in 6-9 year olds. Overall, H. pylori infection had no association with the nutritional state of the child or family income, but the infection rate was 2.5 times higher among children of mothers with no schooling. It is unclear why the infection rate dropped in late infancy. Initial clearance of the infection by the body's defence mechanisms could be responsible, albeit with the possible alteration of the gastric mucosa which sustains infection. Maternal education may be protective and may operate through some unidentified proximate behavioral determinants. The rate of H. pylori infection in infants and young children may predispose them to repeated gastrointestinal infection and diarrhea.